Roxi & possible liver shunt

[Roxi Ree]

First off, I would like to thank everyone for their feedback and I took into consideration all your comments. I've stayed away from the board while I was making my decision on the surgery for Roxi...a coworker said I was driving myself crazy. Yesterday, Roxi had the surgery. She was spayed (he did an Ovariectomy), liver biopsy done, and she did so well that the dentist went ahead and pulled 8 teeth. I just got the phone call this morning that she did really well overnite and that I can come and pick her up.

They did not find an external shunt. A very small part of her liver was slightly discolored. All 4 parts of her liver will be biopsied. We should have the results in 3 to 4 days.

I have one tough little cookie

[Ellie May]

Sounds like you made a good decision. With a number like 43 and no plan to spay, then the answer is pretty easy. Too invasive. But if they already have the abdomen open, I lean toward doing it. There is extra risk, but there are more answers too.

My dog's post BAT was just 4 points higher and we did do a biopsy at time of spay. I don't regret it at all. My only regret is that only one sample was taken instead of several. Her liver may be a bit pale, so that tells me perhaps something is going on not just locally. The biopsy did NOT show MVD (and Dr. Powers at CSU interpreted it - I've heard if it's there, she will find it..). So unless Ellie has localized MVD, then she has high bile acids (gone up to 106 since) for another reason. I think in the case of hepaticlipidosis (not common in dogs), they can present with high bile acids but the management for it and MVD aren't the exact same. So jmho, if a vet is in there anyway and wants to biopsy, I let them.

Hopefully it will come back with just a mild case of MVD and she will be able to be medically managed for life.

[nychelse]

poor baby...

[ArmaniMan]

Just seeing this thread for the first time. My Chloe had a similar experience when she was a puppy- liver seemed perfectly healthy upon examination but bile acid results were high. We did the same thing- biopsy at time of spay. It did come back positive for MVD, I am very glad we did it- so that we know exactly what is wrong with her and can handle it from there. She is on a low protein diet, no special supplements, and she has had no symptoms. I will keep your little one in my thoughts.

[Roxi Ree]

Originally Posted by Ellie May

Sounds like you made a good decision. With a number like 43 and no plan to spay, then the answer is pretty easy. Too invasive. But if they already have the abdomen open, I lean toward doing it. There is extra risk, but there are more answers too.

My dog's post BAT was just 4 points higher and we did do a biopsy at time of spay. I don't regret it at all. My only regret is that only one sample was taken instead of several. Her liver may be a bit pale, so that tells me perhaps something is going on not just locally. The biopsy did NOT show MVD (and Dr. Powers at CSU interpreted it - I've heard if it's there, she will find it..). So unless Ellie has localized MVD, then she has high bile acids (gone up to 106 since) for another reason. I think in the case of hepaticlipidosis (not common in dogs), they can present with high bile acids but the management for it and MVD aren't the exact same. So jmho, if a vet is in there anyway and wants to biopsy, I let them.

Hopefully it will come back with just a mild case of MVD and she will be able to be medically managed for life.

I was leaning towards not doing the biopsy, but because I had to get her spayed, I did decide to do it and I don't regret it. I felt she had a very competent surgeon. I am a HUGE worrier and as a coworker pointed out to me, I would always be worrying about what was wrong with her. And I haven't really been enjoying Roxi because I am always looking for "signs" of illness. This way hopefully we find out what we're dealing with and we can go from there. I've lost a few animals due to bad decisions on my part of not seeking medical attention until too late and I didn't want this to happen to my little girl. I can't wait to get my little furbutt back. I'm picking her up this afternoon (I've been missing too much work or I would've picked her up right after the phone call).

[Ringo1]

I'm glad Roxi came through it ok and that you will be getting some answers!

Yes, doing the biopsy at the time of spay seems like a good idea.

Keep us posted!

[Roxi Ree]

Ok, so Roxi's home now. The little spitfire doesn't even act like she has had anything done to her. The problem is I can't keep her from jumping. I had her in her pen with her carrier, food, water and pee pad. But she keeps jumping trying to get out. She can do this for hours. I even caught her on top of the carrier trying to jump out of pen. So the carrier is gone and only her bed is in the pen now. I slept on the floor with her last night (this 50 yr old body didn't handle that well). I've even covered her pen up with a blanket hoping to calm her down. I'm at a point it might be better to just let her roam the house, but I already caught her on a chair (for being only 2.5 lbs, this little girl can jump). I'm starting to think she's part cat. Her incision already looks like it has started bleeding. I'm definitely calling surgeon first thing this morning. He said that his staff had problems getting her to stop jumping at them...she really loves people. Any ideas on how to keep her calm? Maybe some doggie valiums? This is going to be a rough 2 weeks. Oh, and she is eating really good. I was really worried about that so one less thing to worry about.

[Ellie May]

Ellie is like that too. Put a cover on the pen and she just jumps into it. She finally learned to settle down a bit. But in this case with an incision and liver biopsy, she has to be still. Have you tried just the little crate with the door closed? That is really where she should be right now. If the incision opens, abscesses, something is torn, or too much movement causing internal issues, she will more than likely need another surgery.

Most vets would hesitate to sedate at home if the dog is already on pain meds. Sedatives are also hard on the liver.

[Roxi Ree]

Roxi had a rough weekend. She had soft poo and started throwing up. I couldn't get her to eat. Spent most of the time sleeping. I called the Emergency Vet Sunday morning and we decided to take her off the Metacam. By Sunday afternoon, she was so weak and I was ready to take her back to the Emergency Center, but I tried one more thing...I had a couple of cans of canned food (she usually eat dry). She ate 1/2 a can and was back to her old self. I guess she was on a hunger strike.

The surgeon just called me with the results of her biopsy. She does have a very mild case of MVD in the portal region. We are going to manage with a change of food only (he doesn't feel the need for supplements at this time).

Here's my question for you guys: Both the surgeon and my regular vets are going with the Hill's l/d. I'm not real big on canned food, but they say they can only get the dry in 20 lb bags (and nobody is sure about the size of the kibble...Roxi's only 2.6 lbs). My regular vets are looking into the Royal Canin to see what's available. What do guys use for your babies? I really would appreciate your feedback.

[107barney]

Originally Posted by Roxi Ree

Roxi had a rough weekend. She had soft poo and started throwing up. I couldn't get her to eat. Spent most of the time sleeping. I called the Emergency Vet Sunday morning and we decided to take her off the Metacam. By Sunday afternoon, she was so weak and I was ready to take her back to the Emergency Center, but I tried one more thing...I had a couple of cans of canned food (she usually eat dry). She ate 1/2 a can and was back to her old self. I guess she was on a hunger strike.

The surgeon just called me with the results of her biopsy. She does have a very mild case of MVD in the portal region. We are going to manage with a change of food only (he doesn't feel the need for supplements at this time).

Here's my question for you guys: Both the surgeon and my regular vets are going with the Hill's l/d. I'm not real big on canned food, but they say they can only get the dry in 20 lb bags (and nobody is sure about the size of the kibble...Roxi's only 2.6 lbs). My regular vets are looking into the Royal Canin to see what's available. What do guys use for your babies? I really would appreciate your feedback.

I'm sorry she's not feeling well.

Regarding the food - the Hill's canned L/D is much higher in fat than the kibble. I used it for my dog Daisy for about 2.5 years because it was all she could eat. Now that she is older she can't tolerate it due to her allergies and it made her blood very lipemic (fatty). She also cannot eat the Hill's kibble.

The Royal Canin Hepatic LS is a slightly smaller kibble than the Hill's. My dog could not tolerate that either.

If you're doing to go with the Hill's canned L/D, I have about 6-8 cans of it that I can't use, would be happy to send them to you, the food is fresh, I had ordered two cases but then Daisy stopped tolerating it. I've been hanging on to it in case someone on YT wanted it.

[107barney]

Also, you can freeze the kibble to make it last longer if you buy the large bag. It does only come in the large size. There are other options besides Hill's....
Royal Canin Hepatic
Royal Canin Vegetarian
Purina HA

These are diets I've been using and considering for my dog. Purina HA has a larger kibble. RC uses natural preservatives and Hill's doesnt. There are lots of plusses and minuses to each food.

[Ringo1]

Natural Balance makes a vegetarian kibble too - though it's not prescription. Lucy ate it pretty well for about a year then went off it.

I think it would be great if you could try the canned and just see how she does.

[Roxi Ree]

Originally Posted by 107barney

I'm sorry she's not feeling well.

Regarding the food - the Hill's canned L/D is much higher in fat than the kibble. I used it for my dog Daisy for about 2.5 years because it was all she could eat. Now that she is older she can't tolerate it due to her allergies and it made her blood very lipemic (fatty). She also cannot eat the Hill's kibble.

The Royal Canin Hepatic LS is a slightly smaller kibble than the Hill's. My dog could not tolerate that either.

If you're doing to go with the Hill's canned L/D, I have about 6-8 cans of it that I can't use, would be happy to send them to you, the food is fresh, I had ordered two cases but then Daisy stopped tolerating it. I've been hanging on to it in case someone on YT wanted it.

Thank you very much for the offer. I will let you know. I always thought that it is better to have dogs on dry because of their teeth (especially Yorkies)...at least that's what I have read. I had a minature poodle that I had on canned food and I lost him to an infection due to an infected tooth. Since then I've always tried to keep my babies on dry kibble and that is what my vet has always suggested. But like right now, canned is all that I can get Roxi to eat.

[Ellie May]

I agree with Cathy. L/D is a great product. The canned is fine to try, but unfortunately because it's high in fat, it may trigger a case of prancreatitis faster than some other foods. Wouldn't worry about the teeth too much. Kibble being better for the teeth isn't totally wrong, but it's way overstated. Whatever you feed, the teeth shouldbe brushed daily. I'd pick the diet that works for her and brush the teeth.

The RC Hepatic kibble is fine. Works for some and not for others. I'd have to go back to the beginning of this thread to see what kinds of symptoms there were, but if I remember right there were very few. In dogs with bile acids as low as your girl's with few or no symptoms (and no neurological symptoms), such a protein restriction (from rx liver diets) is usually considered unnecessary.

The Metacam could have very well caused an issue. Most vets that deal with liver disease opt for a drug that is safer for the liver like Tramadol or Buprenorphine.

[TLC]

I am using the Royal Canin Hepatic LS 14.

If you send me your addy via PM - I will gladly send some your way if you would like to try it out! My two LOVE the kibble and are doing very well on it.

My Vet doesn't stock the RCH either, but order it for me when ever I need it. It does come in a 6lbs small size bag as well

Let me know if you want some to try out?